The most interesting medical cases of the week

A 25-year-old woman with no clinically significant medical history went bungee jumping from a vertical height of 150 ft (45.7 m). Immediately afterward, she noticed a substantial decrease in vision in her left eye, with a large central scotoma; no other symptoms were noted and there was no pain… the foveal and macular architecture was obscured by a large macular hemorrhage just below the level of the internal limiting membrane (Panel B, arrow).

A man in Vancouver, Canada, has discovered the hard way that listening to earphones in a thunderstorm can be a very bad idea. He was jogging while listening to an iPod, when he was struck by lightning. The earphones conducted the electricity through his head, bursting his eardrums and fracturing his jaw.

A 56-year-old woman presented with jaundice and a painless mass in her left supraclavicular fossa that had become progressively enlarged during the preceding 8 weeks. Physical examination revealed a hard lymph node measuring 6 cm by 6 cm in the left supraclavicular fossa (Panel A) and hepatomegaly… Endoscopy of the upper gastrointestinal tract showed a fungating mass around the ampulla of Vater.

A man with an unusually tiny brain manages to live an entirely normal life despite his condition, which was caused by a fluid build-up in his skull. Scans of the 44-year-old man’s brain showed that a huge fluid-filled chamber called a ventricle took up most of the room in his skull, leaving little more than a thin sheet of actual brain tissue (see image, right).